No abstract available.
Ligaments* ; Pelvic Organ Prolapse*

PURPOSE: The aim of this study was to investigate the effects of extracorporeal shock wave therapy (ESWT) an lateral epicondylitis of the elbow. MATERIALS AND METHODS: Twenty-four patients with refractory lateral epicondylitis were treated with shock waves. The patients were evaluated by assessing of pain using visual analog scale (VAS) and a simple elbow test (SET). Overall clinical outcomes were evaluated using Roles and Maudsley scores at 12 months after ESWT. RESULTS: Significant symptom improvement were observed in 20 (83%) patients at the 12 months follow up according to the Roles and Maudesley scores. Average SET and VAS scores were also significantly improved after ESWT (p<0.05). CONCLUSION: This study suggests that shock waves therapy could be considered as an effective and noninvasive treatment modality for refractory lateral epicondylitis of the elbow.
Elbow ; Follow-Up Studies ; Humans ; Shock ; Tennis Elbow* ; Tennis* ; Visual Analog Scale

Hantaviruses are members of the family Bunyaviridae, the etiologic agents of Hemorrhagic fever with renal syndrome (HFRS) and Hantavirus Pulmonary Syndrome (HPS). They are negative-sense, single-stranded RNA viruses possessing a large (L), medium (M) and small (S) genomic segment which encodes a viral polymerase, envelope glycoproteins (G1 and G2) and a nucleocapsid (N) protein, respectively. Seoul (SEO) virus, the causative agent of clinically mild HFRS in worldwide, was isolated from lung tissues of urban rat (Rattus norvegicus) captured in Seoul, Korea, 1982. To clarify the antigenic characteristics and the differentiation of serotypes of hantavirus, 8 hybridoma cell lines secreting monoclonal antibodies (MAbs) against SEOV 80-39 strain were produced by fusion of SP2/0-Ag14 mouse myeloma cells with spleen cells of BALB/c mice, immunized with SEOV. Reactivities of these MAbs were examined by the indirect immunofluorescence assay (IFA), enzyme linked immunosorbent assay (ELISA), immunoblot, high density particle agglutination (HDPA) and plaque reduction neutralization test (PRNT). Eight out of 235 hybridomas secreted MAbs of Seoul virus 80-39 continuously, and these eight MAbs were all IgG. The isotypes of these 8 MAbs are; one clone (F3-3C) was IgG1, six (F1-1B9B, F1-3B, F1-3D, F4-1E, F4-3F, F4- 6C) were IgG2a and one (F1-1B9F) was IgG2b. Seven MAbs (F1-1B9B, F1-1B9F, F1-3B, F1- 3D, F3-3C, F4-1E, F4-3F) reacted with nucleocapsid protein (M.W. 50K) of SEOV by immunoblot. All eight MAbs were cross-reacted with Hantaan (HTN) virus, one (F4-3F) was cross-reacted with Puumala (PUU) virus and two (F1-1B9B, F1-3B) were cross-reacted with Prospect Hill (PH) virus by IFAT. None of these 8 MAbs had neutralizing activity.
Agglutination ; Animals ; Antibodies, Monoclonal* ; Bunyaviridae ; Cell Line ; Clone Cells ; Enzyme-Linked Immunosorbent Assay ; Fluorescent Antibody Technique, Indirect ; Glycoproteins ; Hantavirus ; Hantavirus Pulmonary Syndrome ; Hemorrhagic Fever with Renal Syndrome ; Humans ; Hybridomas ; Immunoglobulin G ; Korea ; Lung ; Mice ; Neutralization Tests ; Nucleocapsid ; Nucleocapsid Proteins ; Rats ; RNA Viruses ; Seoul virus* ; Seoul* ; Spleen

Leptospirosis has been known as endemic disease in Korea since 1984. Wild rodent, mostly Apodemus agrarius, has been known as an important source of leptospiral infection especially in rainy circumstances in harvest reason of rural area. The infection rates of Leptospira interrogans in field rodents, Apodemus agrarius, was investigated by culture and PCR detection of leptospiral DNA, and compared with previous data. Furthermore, the serogroup and serovar were investigated. Two hundred twenty two Apodemus agrarius were captured during October to December 1996. Spirohaetes were isolated from 22 (9.9%) and leptospiral DNA was detected in an additional six rodents (12.6%). Subsequent cross-agglutinin absorption test, monoclonal antibody reactivity classified 21 cultures among 22 isolates as Leptospira interrogans serogroup Icterohemorrhagiae serovar lai. The above data did not differ from previous survey in 1984 to 1987. There was no significant change of Leptospira interrogans infection in field rodents in Korea.
Absorption ; Animals ; DNA ; Endemic Diseases ; Korea* ; Leptospira interrogans* ; Leptospira* ; Leptospirosis ; Murinae ; Polymerase Chain Reaction ; Prevalence* ; Rodentia*

We have experienced 19 patients of the cerebral arteriovenous malformation with subarachnoid hemorrhage, who were admitted to the Presbyterian Hospital, Daegu from January 1966 to July 1968, and to the Catholic Medical Center, Seoul from August 1968 to August 1971. All of the patients, who have the cerebral arteriovenous malformation, were proved by cerebral angiography. Since the site of lesions were considered to have close relation to the neurologic deficit and the result of surgery, various analysis of the clinical manifestations and the cerebral angiographic findings were attempted. Of the 19 patients, surgery was performed on 12 patients and its results were analyzed correlating to various types of surgical procedure. Following are the results. 1. From January 1966 to August 1971, there were 100 cases of cerebral vascular anomalies which were proved by cerebral angiography. Among the 100 cases, there were 71 intracranial aneurysms, 19 cerebral arteriovenous malformations, one cavernous angioma, 2 telangiectasis, 5 cerebral rete mirabile, and s Sturge Weber-Dimitris disease. The ratio of arteriovenous malformatons to aneurysms was 1: 3.7. 2. Age distribution of the bleeding arteriovenous malformations was ranged from 8 to 54, and 42 per cent of them were in the third decade. 73 percent of the group had bleeding from the cerebral arteriovenous malformation before the age of 40. The ratio of male to female was 1.9:1. 3. The parietal region was most commonly involved by the malformations. There were 8 parietal lesion, 4 temoroparietal lesions, one temporal lesion, one occipital lesion, and one tela chorioidea lesion. Simultaneous involvement of the both hemispheres occurred in one case. In lesions involving the cerebral hemisphere, there was a predominance of the left side. 4. In the past history, convulsive seizure was recorded in two cases and recurrent hemorrhages were reported in two. One patient was recorded to have suffered fourth hemorrhage and the other have sufferd third hemorrhge. 5. Meningeal irritation signs were most frequently observed in bleeding arteriovenous malformations. The incidence of weakness of extremities was higher in lesions involving the parietal area. Unconsciousness was occurred in 6 patients at the onset of symptom, of which transient loss of consciousness was seen in 3 patients. Transient hypertension at the onset was observed in two patients. 6. The feeding arteries of the malformations were most frequently seen from the middle cerebral artery and the draining veins from the malformations were into the superior sagittal sinus and internal cerebral vein in many cases. It was evident that the carotid artery of the sites of arteriovenous malformations was markedly dilated in 5 patients. 7. Ligation of the vessels feeding the arteriovenous malformations was carried out in 8 patients. One patient had neurologic deficit after the operation. Evacuation of intracerebral hematoma, resection of the anomaly or carotid ligation were carried out in 4 patients. Of the 12 patients who underwent various types of surgery, there was one death after evacuation of a large intracereral hematoma. 8. In our opinion, the ligation of feeding artery a choice of procedure to reduce the incidence of rebleeding, if the resection of the lesion was considered to have operative risk by the location of malformations.
Age Distribution ; Aneurysm ; Arteries ; Arteriovenous Malformations ; Carotid Arteries ; Cerebral Angiography ; Cerebral Veins ; Cerebrum ; Daegu ; Extremities ; Female ; Hemangioma, Cavernous ; Hematoma ; Hemorrhage ; Humans ; Hypertension ; Incidence ; Intracranial Aneurysm ; Intracranial Arteriovenous Malformations ; Ligation ; Male ; Middle Cerebral Artery ; Neurologic Manifestations ; Protestantism ; Rabeprazole ; Seizures ; Seoul ; Subarachnoid Hemorrhage ; Superior Sagittal Sinus ; Telangiectasis ; Unconsciousness ; Veins

BACKGROUND: The resistance of Streptococcus pneumoniae to penicillin has been rapidly increasing during the recent three decades. In Korea, we found the incidence of penicillin resistance (PR) to pneumococci was 81% for the clinical isolates in our hospital, and 89% for the colonizing isolates of day-care center around Seoul. Alterations in penicillin-binding protein (PBP) 2B gene have been known to be associated with a resistance to penicillin. We tried to reveal the characteristics of PR of Korean pneumococcal strains through sequencing analysis of PBP 2B gene. METHODS: We determined the nucleotide sequences of 346 bp of a variable region among PBP 2B gene for 12 PR strains and 6 penicillin susceptible (PS) strains isolated in Korea. Phylogenetic tree using PAUP program was made to compare our DNA sequences with those of South African strains. RESULTS: Sequence homology of PS strains was ranged from 99.4% to 100% in Korean PS strain compared to reference strain, R6, except one strain (93.9%). PR strains showed homology of 95.1% to 100% compared to the South African 56762 strain. Phylogenetic analysis based on 346 bp of PBP 2B gene showed that Korean and South African strains formed different monophyletic groups according to the PR/PS patterns. Five specific amino acid changes compared to the PS R6 strain in the position 228, 232, 233, 244, and 261 were noted with a decreased hydrophilicity by Kyte-Doolittle assay. CONCLUSIONS: Our data suggest that the amino acid changes in the PBP 2B are associated with PR in S. pneumoniae, and that a part of Korean PR strains might be originated from a South African PR strain.
Base Sequence ; Colon ; Hydrophobic and Hydrophilic Interactions ; Incidence ; Korea* ; Penicillin Resistance ; Penicillin-Binding Proteins* ; Penicillins ; Pneumonia ; Seoul ; Sequence Homology ; Streptococcus pneumoniae* ; Streptococcus*

Acardiac twin is a rare complication of multifetal gestation occurring in 1% of monozygotic twin pregnancies and 1 of 35,000 pregnancies. Acardia shows various other defects in addition to the absence of heart and the most common form is the acardius, acephalus, in which there is an absence of the fetal head and thoracic organs. The presence of an acardiac twin requires the normal (or "pump") twin to provide circulation for itself, as well as the acardiac (or "perfused") sibling. The mortality is 100% for the acardiac or perfused twin and for pump twin is about 50%, resulting from heart failure, prematurity, or cord entanglement. We report two cases of acardiac anomalies at 32 weeks gestation in 30 year-old primigravida woman and 26 weeks gestation in 30 year-old multigravida. A brief review of the literature is included.
Adult ; Female ; Head ; Heart ; Heart Failure ; Humans ; Mortality ; Pregnancy ; Siblings ; Twins, Monozygotic

In 1992, Brugada described clinical features of patients with aborted sudden cardiac death who showed no demonstrable heart disease and a peculiar ECG pattern consisting of right bundle branch block and ST-segment elevation in right precordial leads. Recently, We experienced two cases with aborted sudden cardiac death and similar ECG pattern. Physical examination, routine laboratory tests including serum electrolytes, echocardiography, myocardial thallium SPECT, MRI and MIBG scans were within normal limit. Arrhythmias were not induced in treadmill exercise test, and signal averaged ECGs revealed positive late potentials. Coronary angiography showed normal coronary artery with no evidence of induced vasospasm. Polymorphic ventricular tachycardia and ventricular fibrillation were induced by ventricular stimulation. Intravenous administration of flecainide, procainamide augmented ST segment elevation in one patient, and isoproterenol reduced ST segment elevation in the other patient. For prevention of sudden death, ICDs were implanted in the two patients. Ventricular fibrillations occurred in one patient 12 and 13 months after the implantation and were successfully terminated by ICD.
3-Iodobenzylguanidine ; Administration, Intravenous ; Arrhythmias, Cardiac ; Bundle-Branch Block* ; Coronary Angiography ; Coronary Vessels ; Death, Sudden ; Death, Sudden, Cardiac* ; Echocardiography ; Electrocardiography ; Electrolytes ; Exercise Test ; Flecainide ; Heart Diseases ; Humans ; Isoproterenol ; Magnetic Resonance Imaging ; Physical Examination ; Procainamide ; Tachycardia, Ventricular ; Thallium ; Tomography, Emission-Computed, Single-Photon ; Ventricular Fibrillation

A statistical analysis was made on 468 cases of urolithiasis during the period April 1951 to September 1962, and the following data were obtained: 1. The incidence of the patients with the stones was 2.25 percent of total urological outpatients and 25.4 percent of the ward patients. 2. Incidences of urinary calculi are increasing year by year; 3.6 per cent in 1954, 12.8 per cent in 1958, and 20.7 per cent in 1962. 3. The incidence of stones in the upper urinary tract seemed to increase significantly while that of the lower tract did not. The ratio of upper urinary tract calculi over ones in the lower tract (24 : 76 in 1954), reversed with greatly increasing incidence of upper urinary tract calculi (69: 31 in 1962). 4. These stones consisted of renal stone in 14.5 per cent, ureteral stone in 45.6 per cent, bladder stone in 25.6 per cent and urethral stone in 13 per cent. 5. The stones were most commonly found between the ages of 20 to 50. The upper urinary tract calculi were more frequently seen in young adults but in aged and children lower urinary tract calculi were common. 6. The stones were found to occur predominantly in males than in females and the ratio was 5.4 : 1. 7. The upper urinary tract calculi occurred both in the left and right sides with approximately equal frequency. It was estimated that bilateral urinary calculi occurred in 6 per cent of the cases. 8. Multilocations of the stones in the urinary tracts occurred in 7 per cent of the total stones. 9. Seventy-three per cent of the ureteral stones were lodged in the lower ureter. 10. The results of qualitative chemical examination of stones were calcium oxalate in 30.7 per cent, calcium phosphate in 28.5 per cent, apatite in 19.3 per cent, uric acid and calcium phosphate in 9.1 per cent, uric acid and calcium oxalate in 6.8 per cent, uric acid in 3.4 per cent, and carbonate in 2.2 per cent. 11. Three hundred and nine of 468 cases were treated in the clinic. Spontaneous passage occurred in 10.4 per cent, 41.6 per cent were expelled following instrumental manipulation and 18.6 per cent were subjected to surgical intervention.
Calcium ; Calcium Oxalate ; Calculi ; Carbon ; Child ; Female ; Humans ; Incidence ; Male ; Outpatients ; Statistics as Topic* ; Ureter ; Uric Acid ; Urinary Bladder Calculi ; Urinary Calculi ; Urinary Tract ; Urolithiasis* ; Young Adult

Rapid arterial rethrombosis is associated with high-grade residual stenosis and usually occurs at the site of the initial occlusion, resulting in reocclusion of the recanalized artery. Platelets may play an active role in such rethrombosis after thrombolytic-induced clot lysis. Given that glycoprotein IIb/IIIa receptor blockers, like tirofiban, prevent thrombus formation by inhibiting the final common pathway of platelet aggregation, they may be helpful for treating rethrombosis after thrombolysis. A 64-year-old man presented with an acute ischemic stroke due to internal carotid artery (ICA) occlusion. The ICA was recanalized by intravenous thrombolysis but reoccluded shortly after recanalization. The reoccluded ICA was successfully recanalized using intra-arterial tirofiban. A carotid stent was subsequently inserted to relieve severe stenosis and to prevent recurrent stroke. Here, we report a case of rescue treatment of a successfully recanalized ICA by intra- arterial tirofiban. We suggest that rescue use of intra-arterial tirofiban may be effective and safe, especially in hemorrhage prone situations, due to the relatively lower dose of tirofiban compared with intravenous doses.
*Carotid Artery, Internal ; Carotid Stenosis/*drug therapy/radiography/surgery ; Emergency Treatment ; Humans ; Infusions, Intra-Arterial ; Male ; Middle Aged ; Stents ; Tyrosine/administration & dosage/*analogs & derivatives/therapeutic use